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Cardiomegaly

Cardiovascular Medicine · NLM MeSH · updated 2026-10-29 · version 1

Citations verified against PubMedNot yet clinician-reviewed9 referencesApproximately 3 min read

Enlargement of the heart, usually indicated by a cardiothoracic ratio above 0.50.

Table of Contents

1. Definition2. Research landscape3. Reading the evidence4. Open-access studies5. Key reviews6. References7. About this article

Definition and research guide

This page combines a MeSH definition, publication statistics and selected research abstracts. It is a starting point for reading the literature, not a medical textbook or a systematic evidence review.

Content available: 3 complete abstracts (582 words), 9 references. Full article text is not stored or reproduced here; follow the PMID, DOI or PMC links to read the original sources and their access terms.

Definition

Enlargement of the heart, usually indicated by a cardiothoracic ratio above 0.50. Heart enlargement may involve the right, the left, or both heart ventricles or heart atria. Cardiomegaly is a nonspecific symptom seen in patients with chronic systolic heart failure (heart failure) or several forms of cardiomyopathies.

Definition: NLM Medical Subject Headings (MeSH) scope note (Public domain (U.S. National Library of Medicine); attribution requested). View the MeSH record.

Also known as: Enlarged Heart; Heart, Enlarged; Heart Enlargement; Enlargement, Heart; Cardiac Hypertrophy; Cardiac Hypertrophies; Hypertrophies, Cardiac; Hypertrophy, Cardiac.

Where it fits in the MeSH classification

Broader topics
Heart Diseases; Hypertrophy
Narrower topics
Cardiomyopathy, Dilated; Hypertrophy, Left Ventricular; Hypertrophy, Right Ventricular

Related concepts

  • Heart
  • Heart Ventricles
  • Heart Atria
  • Heart Failure
  • Cardiomyopathies

Research landscape

PubMed indexes 61,437 records tagged with the MeSH heading “Cardiomegaly” (counts retrieved 2026-10-29). 7,404 of them (12.1%) were published from 2020 onward, and the busiest period so far is through 1999 with 24,178 records.

Reviews account for 6,758 records (11.0%) and meta-analyses for 237. Randomized controlled trials number 1,248 (2.0%) as a share of all records on the topic.

PubMed records by publication periodthrough 1999: 24,178 records; 2000-2009: 14,591 records; 2010-2019: 15,264 records; 2020 onward: 7,404 records24,178through 199914,5912000-200915,2642010-20197,4042020 onward
Records in PubMed indexed with this heading, by publication period. Real counts from NCBI E-utilities; the final period covers only part of the current year. Volume reflects how much has been published, not how strong the evidence is.
Show the data
PeriodRecords
through 199924,178
2000-200914,591
2010-201915,264
2020 onward7,404
Share of records by publication typeReviews: 11.0 percent; Meta-analyses: 0.4 percent; Randomized controlled trials: 2.0 percentReviews11.0% (6,758)Meta-analyses0.4% (237)Randomized controlled trials2.0% (1,248)
Share of all PubMed records on this heading that carry each publication type. Types overlap with other records, so the shares do not sum to 100%.
Publication-type chart data
Publication types among 61,437 PubMed records
TypeRecordsShare
Reviews6,75811.0%
Meta-analyses2370.4%
Randomized controlled trials1,2482.0%

Method: PubMed query "Cardiomegaly"[MeSH Terms] with publication-type and date filters, retrieved 2026-10-29.

Reading the evidence in cardiovascular medicine

Cardiovascular medicine has an unusually large body of randomized trials, so the type of outcome matters: hard clinical events such as death, heart attack and stroke carry more weight than changes in blood pressure, cholesterol or imaging markers that only predict risk. Observational studies can show associations but are confounded by age, lifestyle and other illness. Check whether a result is about prevention or treatment, the baseline risk of participants, and the absolute rather than only the relative size of any benefit.

Evidence from open-access studies

These open-access studies come from PubMed’s best-match results for this heading (papers whose main topic it is), ranked here by citation count, with one recent addition. Each abstract is reproduced in full under its recorded open licence so that you can read the authors’ own words. They illustrate the literature; they are not a systematic summary of it. Citation counts measure attention, not reliability or clinical benefit.

Study comparison — selected abstracts, not a systematic review
Study / authorsYearSource label / designEurope PMC citationsLicence / source
Left ventricular hypertrophy and myocardial fibrosis in heart failure with preserved ejection fraction: mechanisms and treatment
Peikert A, Fontana M, Solomon SD, Thum T
2026Review article
Design not recorded in structured metadata
31cc by
PMID 40892534 · DOI · PMC12765563
Rac1 palmitoylation is required for cardiac stress adaptation and regulation of protein kinase A signaling
Teuber JP, Scissors RE, Subramani A, Madamanchi N, Brody MJ
2025Research article
Design not recorded in structured metadata
6cc by
PMID 40924486 · DOI · PMC12581661
Molecular determinants of cardiac lymphatic dysfunction in a chronic pressure-overload model
Heron C, Lemarcis T, Laguerre O, Bourgeois B, Thuilliez C, Valentin C, et al.
2026Research article
Design not recorded in structured metadata
5cc by
PMID 41381806 · DOI · PMC12808729

Left ventricular hypertrophy and myocardial fibrosis in heart failure with preserved ejection fraction: mechanisms and treatment [1]

Review article Peikert A, Fontana M, Solomon SD, Thum T · · 2026 · cited 31 times (Europe PMC)

Abstract reading summary — source excerpts
Opening excerpt
Heart failure with preserved ejection fraction (HFpEF) accounts for nearly half of all heart failure cases and is characterized by phenotypical heterogeneity with a high prevalence of multiple, often overlapping cardiometabolic disorders.
Closing excerpt
This review elaborates on the pathophysiological role of fibrotic remodelling and LV hypertrophy in HFpEF, outlines contemporary diagnostic standards, and discusses emerging therapeutic strategies, aiming at directly modulating myocardial fibrosis and hypertrophy in HFpEF.
Interpretation limits
Verbatim excerpts from the authors’ abstract; the closing excerpt may describe a finding, limitation or recommendation. Design, population, effect size and uncertainty have not been independently extracted or appraised. Read the complete abstract and linked paper before interpreting the findings.
Read complete abstract (199 words)

Heart failure with preserved ejection fraction (HFpEF) accounts for nearly half of all heart failure cases and is characterized by phenotypical heterogeneity with a high prevalence of multiple, often overlapping cardiometabolic disorders. Comorbidities such as hypertension, obesity, or diabetes are present in many HFpEF patients and are hypothesized to contribute to adverse cardiac remodelling and myocardial fibrosis through a variety of haemodynamic and metabolic impairments, with nearly half of all HFpEF patients exhibiting left ventricular (LV) hypertrophy or concentric remodelling. Myocardial fibrosis and its surrogate changes in LV structure and geometry lead to functional impairments such as increased diastolic stiffness and elevated filling pressures and are associated with reduced exercise tolerance and poor prognosis in patients with HFpEF. Despite recent therapeutic progress, there are currently no evidence-based therapies mechanistically focusing solely on myocardial fibrosis and LV hypertrophy in HFpEF. Recognizing myocardial fibrosis and LV hypertrophy as key features of the heterogeneous HFpEF pathophysiology may contribute to the development of promising targets for future clinical trials. This review elaborates on the pathophysiological role of fibrotic remodelling and LV hypertrophy in HFpEF, outlines contemporary diagnostic standards, and discusses emerging therapeutic strategies, aiming at directly modulating myocardial fibrosis and hypertrophy in HFpEF.

Abstract reproduced from the open-access article under the recorded cc by licence; © the authors. PMID 40892534 · DOI · PMC12765563

Rac1 palmitoylation is required for cardiac stress adaptation and regulation of protein kinase A signaling [2]

Research article Teuber JP, Scissors RE, Subramani A, Madamanchi N, Brody MJ · · 2025 · cited 6 times (Europe PMC)

Abstract reading summary — source excerpts
Opening excerpt
Cardiac hypertrophy is a common adaptation to cardiovascular stress and often a prelude to heart failure.
Closing excerpt
Taken together, this study suggests Rac1 S-palmitoylation dampens adrenergic drive and PKA-dependent modulation of the phospho-proteome in response to cardiovascular stress, revealing essential functions for S-acylated Rac1 in cardiac adaptation.
Interpretation limits
Verbatim excerpts from the authors’ abstract; the closing excerpt may describe a finding, limitation or recommendation. Design, population, effect size and uncertainty have not been independently extracted or appraised. Read the complete abstract and linked paper before interpreting the findings.
Read complete abstract (205 words)

Cardiac hypertrophy is a common adaptation to cardiovascular stress and often a prelude to heart failure. We examined how S-palmitoylation of the small GTPase, Ras-related C3 botulinum toxin substrate 1 (Rac1), impacts cardiomyocyte stress signaling. Mutation of the Cys-178 palmitoylation site impaired activation of Rac1 when overexpressed in cardiomyocytes. Cardiomyocyte-specific Rac1 conditional knockin (Rac1cKI) mice expressing a Rac1C178S mutant protein exhibited normal cardiac structure and function but developed more severe cardiac hypertrophy in response to angiotensin II (AngII) infusion, cardiomyocyte-specific overexpression of AngII type 1 receptor (AT1R), and cardiac pressure overload. Moreover, pressure overload and AT1R overexpression evoked cardiac failure phenotypes in Rac1cKI mice not observed in controls. Mechanistically, Rac1cKI hearts and cardiomyocytes genetically resistant to Rac1 S-palmitoylation had a profound increase in protein kinase A (PKA) substrate phosphorylation in response to acute β-adrenergic stimulation, as did Rac1cKI hearts subjected to chronic AngII treatment, AT1R overexpression, or pressure overload that correlates with more advanced heart failure phenotypes. This was not associated with increased PKA enzymatic activity, suggesting potential deficits in phosphatase activity at PKA-regulated phospho-sites. Taken together, this study suggests Rac1 S-palmitoylation dampens adrenergic drive and PKA-dependent modulation of the phospho-proteome in response to cardiovascular stress, revealing essential functions for S-acylated Rac1 in cardiac adaptation.

Abstract reproduced from the open-access article under the recorded cc by licence; © the authors. PMID 40924486 · DOI · PMC12581661

Molecular determinants of cardiac lymphatic dysfunction in a chronic pressure-overload model [3]

Research article Heron C, Lemarcis T, Laguerre O, Bourgeois B, Thuilliez C, Valentin C, et al. · · 2026 · cited 5 times (Europe PMC)

Abstract reading summary — source excerpts
Opening excerpt
Cardiac lymphatic alterations and insufficient lymphatic drainage have been found in cardiovascular diseases (CVDs).
Closing excerpt
Our work provides tractable targets to restore lymphatic health in CVDs.
Interpretation limits
Verbatim excerpts from the authors’ abstract; the closing excerpt may describe a finding, limitation or recommendation. Design, population, effect size and uncertainty have not been independently extracted or appraised. Read the complete abstract and linked paper before interpreting the findings.
Read complete abstract (178 words)

Cardiac lymphatic alterations and insufficient lymphatic drainage have been found in cardiovascular diseases (CVDs). To unravel the mechanisms underlying lymphatic dysfunction, we applied single-cell (sc) analyses in murine heart failure (HF) models. Transaortic constriction (TAC) in C57BL/6J and BALB/c mice modeled chronic pressure -overload-induced cardiac hypertrophy and HF, respectively. Cardiac lymphatic (LEC) and blood vascular endothelial cells (BEC) were analyzed by scRNAseq, and targets validated by immunohistochemistry and human LEC cultures. While LEC profiles were comparable between strains in healthy mice, we found expansion of lymphatic capillaries and loss of valves post-TAC only in BALB/c. Differentially expressed gene (DEG) analysis revealed a reduction post-TAC only in BALB/c of lymphatic junctional components. Conversely, LEC expression of immune cell cross-talk mediators was mostly preserved post-TAC. Interestingly, around 35% of DEGs identified in cardiac LECs post-TAC were similarly altered in interleukin (IL)1β-stimulated human LECs. In conclusion, loss of lymphatic valves and dysregulated lymphatic barrier may underlie poor drainage capacity during pressure-overload-induced HF, despite potent lymphangiogenesis and preserved LEC immune attraction. Our work provides tractable targets to restore lymphatic health in CVDs.

Abstract reproduced from the open-access article under the recorded cc by licence; © the authors. PMID 41381806 · DOI · PMC12808729

Key reviews and meta-analyses

The most cited review-type papers among PubMed’s best-match results for this heading, listed with bibliographic details only. Follow the links for the full text and access terms.

  • Research article Shared genetic pathways contribute to risk of hypertrophic and dilated cardiomyopathies with opposite directions of effect [4]
    Tadros R, Francis C, Xu X, Vermeer AMC, Harper AR, Huurman R, et al. · Nat Genet · 2021 · cited 247 times (Europe PMC)
  • Research article Metabolic mechanisms in physiological and pathological cardiac hypertrophy: new paradigms and challenges [5]
    Ritterhoff J, Tian R · Nat Rev Cardiol · 2023 · cited 231 times (Europe PMC)
  • Research article Dilated cardiomyopathy: causes, mechanisms, and current and future treatment approaches [6]
    Heymans S, Lakdawala NK, Tschöpe C, Klingel K · Lancet · 2023 · cited 185 times (Europe PMC)
  • Research article Left-ventricular hypertrophy and obesity: a systematic review and meta-analysis of echocardiographic studies [7]
    Cuspidi C, Rescaldani M, Sala C, Grassi G · J Hypertens · 2014 · cited 158 times (Europe PMC)
  • Research article Pathophysiology of Hypertensive Heart Disease: Beyond Left Ventricular Hypertrophy [8]
    Nwabuo CC, Vasan RS · Curr Hypertens Rep · 2020 · cited 148 times (Europe PMC)
  • Research article Acute myocarditis: aetiology, diagnosis and management [9]
    Lampejo T, Durkin SM, Bhatt N, Guttmann O · Clin Med (Lond) · 2021 · cited 122 times (Europe PMC)

References

  1. Peikert A, Fontana M, Solomon SD, Thum T. Left ventricular hypertrophy and myocardial fibrosis in heart failure with preserved ejection fraction: mechanisms and treatment. . 2026. PMID 40892534 · DOI · PMC12765563
  2. Teuber JP, Scissors RE, Subramani A, Madamanchi N, Brody MJ. Rac1 palmitoylation is required for cardiac stress adaptation and regulation of protein kinase A signaling. . 2025. PMID 40924486 · DOI · PMC12581661
  3. Heron C, Lemarcis T, Laguerre O, Bourgeois B, Thuilliez C, Valentin C, et al.. Molecular determinants of cardiac lymphatic dysfunction in a chronic pressure-overload model. . 2026. PMID 41381806 · DOI · PMC12808729
  4. Tadros R, Francis C, Xu X, Vermeer AMC, Harper AR, Huurman R, et al.. Shared genetic pathways contribute to risk of hypertrophic and dilated cardiomyopathies with opposite directions of effect. Nat Genet. 2021. PMID 33495596 · DOI · PMC7611259
  5. Ritterhoff J, Tian R. Metabolic mechanisms in physiological and pathological cardiac hypertrophy: new paradigms and challenges. Nat Rev Cardiol. 2023. PMID 37237146 · DOI
  6. Heymans S, Lakdawala NK, Tschöpe C, Klingel K. Dilated cardiomyopathy: causes, mechanisms, and current and future treatment approaches. Lancet. 2023. PMID 37716772 · DOI
  7. Cuspidi C, Rescaldani M, Sala C, Grassi G. Left-ventricular hypertrophy and obesity: a systematic review and meta-analysis of echocardiographic studies. J Hypertens. 2014. PMID 24309485 · DOI
  8. Nwabuo CC, Vasan RS. Pathophysiology of Hypertensive Heart Disease: Beyond Left Ventricular Hypertrophy. Curr Hypertens Rep. 2020. PMID 32016791 · DOI
  9. Lampejo T, Durkin SM, Bhatt N, Guttmann O. Acute myocarditis: aetiology, diagnosis and management. Clin Med (Lond). 2021. PMID 34507935 · DOI · PMC8439515

About this article

Sources
NLM Medical Subject Headings (definition, synonyms); NCBI PubMed (counts, identifiers); Europe PMC (open-access abstracts and citation counts).
Verification
Every reference was resolved against PubMed on 2026-10-31; title, year and DOI matched.
Review state
automated source verified; no human expert review has been recorded yet.
Version
1, last updated 2026-10-29.

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All 105 articles in Cardiovascular Medicine →

At a glance

61,437
PubMed records on this heading
12%
published since 2020
6,758
review articles
1,248
randomized trials
9
verified references below

Counts come from PubMed on 2026-10-29; they show how much has been written, not how strong the evidence is.

Related topics See all →

  • Atrioventricular BlockCardiovascular Medicine
  • Atrial FibrillationCardiovascular Medicine
  • Ventricular FibrillationCardiovascular Medicine
  • Ventricular RemodelingCardiovascular Medicine
  • Heart RateCardiovascular Medicine

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Sources

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  • PubMed search used ↗

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